Cara Andréa, Ferry Tristan, Laurent Frédéric, Josse Jérôme
Centre International de Recherche en Infectiologie, CIRI, Inserm U1111, CNRS UMR5308, ENS de Lyon, UCBL1, 69007 Lyon, France.
Université Claude Bernard Lyon 1, 69100 Lyon, France.
Antibiotics (Basel). 2022 Jan 21;11(2):137. doi: 10.3390/antibiotics11020137.
Gram-negative bacilli can be responsible for prosthetic joint infection (PJI) even if staphylococci are the main involved pathogens. Gram-negative PJIs (GN-PJI) are considered difficult-to-treat infections due to the increase in antimicrobial resistance and biofilm formation. To minimize the risk of infection in cases of arthroplasties with cemented prosthesis, bone cement can be loaded with antibiotics, especially gentamicin. In this study, we aimed to compare the prophylactic antibiofilm activity of ready-to-use antibiotic-loaded bone cements (ALBC), already commercialized or new prototypes. We compared ALBCs containing gentamicin alone, gentamicin plus vancomycin, gentamicin plus clindamycin, gentamicin plus Fosfomycin, and fosfomycin alone, to plain cement (no antibiotic); these comparisons were conducted to investigate the biofilm formation of three strains of , three strains of and two strains of , with or without specific resistance to gentamicin or fosfomycin. We reported that ALBC containing gentamicin and clindamycin (COPAL G+C) seems to be the most interesting ALBC of our tested panel for the prevention of biofilm formation by gentamicin-susceptible strains, even if clindamycin is not effective against Gram-negative bacteria. However, gentamicin-resistant strains are still a problem, and further studies are needed to identify an antibiotic to associate with gentamicin for an efficient dual ALBC against Gram-negative bacteria.
即使葡萄球菌是主要的致病病原体，革兰氏阴性杆菌也可能导致人工关节感染（PJI）。由于抗菌药物耐药性增加和生物膜形成，革兰氏阴性人工关节感染（GN-PJI）被认为是难以治疗的感染。为了将使用骨水泥假体的关节成形术感染风险降至最低，骨水泥可以加载抗生素，尤其是庆大霉素。在本研究中，我们旨在比较已商业化或新原型的即用型载抗生素骨水泥（ALBC）的预防性抗生物膜活性。我们将单独含有庆大霉素、庆大霉素加万古霉素、庆大霉素加克林霉素、庆大霉素加磷霉素以及单独使用磷霉素的ALBC与普通骨水泥（无抗生素）进行比较；进行这些比较是为了研究三株[具体细菌名称1]、三株[具体细菌名称2]和两株[具体细菌名称3]在有无对庆大霉素或磷霉素的特异性耐药情况下的生物膜形成情况。我们报告称，含有庆大霉素和克林霉素的ALBC（COPAL G+C）似乎是我们测试组中预防庆大霉素敏感菌株形成生物膜最有意义的ALBC，即使克林霉素对革兰氏阴性菌无效。然而，耐庆大霉素菌株仍然是一个问题，需要进一步研究以确定一种与庆大霉素联合使用的抗生素，用于开发一种有效的针对革兰氏阴性菌的双重ALBC。
